Skin preparation type and post-cesarean infection with use of adjunctive azithromycin prophylaxis.
Skin preparation type and post-cesarean infection with use of adjunctive azithromycin prophylaxis.
复制标题
备皮类型和剖宫产后感染并使用阿奇霉素辅助预防。
DOI：
10.1080/14767058.2020.1797665
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Tita,A
中科院分区：
文献类型：
--
作者：
Ausbeck,ElizabethB;Jauk,VictoriaC;Boggess,KimA;Saade,George;Longo,Sherri;Esplin,Sean;Cleary,Kirsten;Wapner,Ronald;Letson,Kellett;Owens,Michelle;Blackwell,Sean;Ambalavanan,Namasivayam;Szychowski,JeffM;Andrews,William;Tita,A
ObjectiveTo compare the frequency of postoperative surgical site infection (SSI) by type of skin preparation used for unscheduled cesarean in the setting of adjunctive azithromycin prophylaxis.MethodsSecondary analysis of a multi-center randomized controlled trial of adjunctive azithromycin (500 mg intravenous) versus placebo in women who were ≥24 weeks gestation and undergoing unscheduled cesarean (i.e. during labor or ≥4 h after membrane rupture). Type of skin preparation used was identified based on the protocol at the hospital at the time of delivery: iodine-alcohol, chlorhexidine, chlorhexidine-alcohol, or the combination of chlorhexidine-alcohol and iodine. The primary outcome of this analysis was incidence of post-operative SSI, as defined by CDC criteria. Multivariable logistic regression was applied for adjustments.ResultsAll 2013 women in the primary trial were included in this analysis. Women were grouped according to type of skin preparation received: iodine-alcohol (n= 193), chlorhexidine (n= 733), chlorhexidine-alcohol (n= 656), and chlorhexidine-alcohol and iodine combined sequentially (n= 431). The unadjusted rates of wound infection ranged from 2.9% to 5.7%. Using iodine-alcohol as the referent, the adjusted odds ratios for wound SSI were 0.71 (95% CI 0.30–1.66) for chlorhexidine, 0.97 (95% CI 0.41–2.28) for chlorhexidine-alcohol, and 0.88 (95% CI 0.36–2.20) for chlorhexidine-alcohol with iodine combination.ConclusionIn women undergoing unscheduled cesarean delivery in a trial of adjunctive azithromycin, the type of skin preparation used did not appear to be associated with the frequency of wound SSI.
